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Investor Webcast62nd Annual Meeting & ExpositionAmerican Society of Hematology
December 8, 2020
A G L O B A L L E A D E R I N G E N E T H E R A P Y | 2D E C E M B E R 8 , 2 0 2 0
This presentation contains forward-looking statements. All statements other than statements of historical fact areforward-looking statements, which are often indicated by terms such as "anticipate," "believe," "could," "estimate,""expect," "goal," "intend," "look forward to", "may," "plan," "potential," "predict," "project," "should," "will," "would" andsimilar expressions. Forward-looking statements are based on management's beliefs and assumptions and oninformation available to management only as of the date of this press release. These forward-looking statementsinclude, but are not limited to, whether clinical data from the HOPE-B Phase III pivotal trial will be included inregulatory submissions to the FDA and EMA in the second half of 2021 or ever, whether the clinical data proves tobe meaningful for the long-term outlook for hemophilia gene therapy or etranacogene dezaparvovec, whetheretranacogene dezaparvovec has the potential to lead to increases in FIX activity in the normal range and providewell-tolerated, long-term clinical benefits, whether AAV5-based gene therapies can provide clinical benefit topatients with pre-existing neutralizing antibodies, and whether we will obtain regulatory approval of our agreementwith CSL Behring or otherwise close the transaction. Our actual results could differ materially from thoseanticipated in these forward-looking statements for many reasons, including, without limitation, risks associated withour and our collaborators’ clinical development activities, clinical results, collaboration arrangements, corporatereorganizations and strategic shifts, regulatory oversight, product commercialization and intellectual property claims,as well as the risks, uncertainties and other factors described under the heading "Risk Factors" in uniQure’sQuarterly Report on Form 10-Q filed on October 27, 2020. Given these risks, uncertainties and other factors, youshould not place undue reliance on these forward-looking statements, and we assume no obligation to update theseforward-looking statements, even if new information becomes available in the future.
Forward-looking Statements
Hemophilia BClinical Data Presentations
at ASH 2020
Steven Pipe, M.D.Professor of Pediatrics & Pathology
Pediatric Medical Director, Hemophilia & Coagulation Disorders Program
University of Michigan
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Goal of gene therapy in hemophilia B:
Transformation of disease severity
▪ Establish long-term benefit with sustained FIX activity from a one-time procedure
▪ Control of bleeding with effective protection against bleeds
▪ Elimination of the requirement for continuous prophylaxis
▪ Improvement in quality of life
Table adapted from Srivasta A, et al. Hemophilia. 2020;26:1-158
PhenotypeSpontaneous
bleeding
Prophylaxis
recommendedFIX activity
Severe frequent yes <1%
Moderate rare variable 1-5%
Mild very rare no 5-40%
Normative no no >40%
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▪ Etranacogene dezaparvovec (AAV5-Padua hFIX):
▪ Developed by combining the AAV5 vector from AMT-060 (AAV5-WT hFIX) with the naturally occurring Padua FIX variant
▪ Enhanced version of AMT-060, which demonstrated efficacy and safety in a Phase 1/2 trial (N=10)1
▪ Stable expression of WT FIX at 4.5-5 years2
▪ No late-emergent safety signals2
▪ A Phase 2b study long-term follow-up is ongoing3,4
▪ Mean FIX activity at 2 years was 44.2% with no new treatment-related AEs.
▪ HOPE-B is the first Phase 3 study in hemophilia B and has the largest gene therapy cohort to date
Etranacogene dezaparvovec
AE, adverse event; WT, wild type.
1. Miesbach W, et al. Blood. 2018;131:1022-1031.
2. Leebeek FWG, et al, ASH 2020; Poster #33724.
3. Von Drygalski A, et al. Blood Adv. 2019;3:3241-3247.
4. Von Drygalski A, et al, ASH 2020; Oral presentation #672.
AAV5
Etranacogene dezaparvovec:
Hyperactive FIX Padua variant
Human wild type FIX (codon optimized)
with 2 nucleotide adaptation
LP-1
(Liver-specific
promoter)
Hyperactive Padua variant
AAV; adeno-associated virus; FIX, Factor IX; wt, wildtype
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HOPE-B pivotal trial: study design
Key inclusion criteria
• Male adults ≥18 years
• FIX activity ≤2% of normal
• Continuous prophylaxis for ≥2 months
Key exclusion criteria
• Factors that might affect the evaluation of AMT-
061 efficacy or safety, e.g.
• FIX inhibitors
• Active hepatitis B/C infection
• Uncontrolled HIV infection
Pre-existing anti-NAbs were assessed, but not
used as an exclusion criteria
No prophylactic immunosuppression
HIV, human immunodeficiency virus; NAbs, neutralizing antibodies; wks, weeks.
~ 4 wks
~ 4 wks
Screening visit
Long-term
follow upEvery 6 months
Post-treatment
follow up Monthly visits
Weekly visits
Dosing visitSingle dose of AMT-061
2×1013 gc/kg
Lead-in phase
(26 weeks)
Visits every 2 months,
phone calls on alternating
months
Week 1
Week 12
Month 12
Month 60
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• Primary endpoints
• FIX activity (central one stage aPTT) at 26 weeks after dosing
• FIX activity 52 weeks after dosing*
• 52-week ABR compared to lead-in*
• Secondary endpoints
• Rates of total, spontaneous, traumatic, and treated/untreated bleeds
• FIX consumption
• Correlation of FIX activity levels and safety with pre-AMT-061 anti-AAV5 antibody titers over 26 weeks
follow up
• Safety
*Planned co-primary endpoints; aPTT, activated partial thromboplastin time; ABR, annualized bleeding rate; NAbs, neutralizing antibodies.
HOPE-B pivotal trial: study endpoints
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aOr equivalent scan (magnetic resonance elastography, shear wave elastography).
bFAS, full analysis set includes subjects who enrolled, entered the lead-in phase, were dosed with AMT-061 and provided ≥1 efficacy endpoint assessment.
cPer-Protocol population (N = 53), which included all subjects from the FAS who adhered to a stable and adequate prophylaxis use during the lead-in phase, completed assessments through the 6-month visit, and had no major protocol deviations
that impacted the interpretation of efficacy
HOPE-B pivotal trial: patient disposition
75 patients screened
Ineligible fibroscana score,
concomitant medication,
co-morbidities, withdrawn due
to Covid-19 pandemic, or
withdrawn consent
13 patients discontinued
prior to dosing
▪ 54 patients were dosed and completed 26-weeks of follow up
54 patients dosed
(FAS population)b,c
8 screen failures 67 entered lead-in phase
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Full analysis set
(N = 54)
Age, mean (SD, min-max), years 41.5 (15.8, 19-75)
Severity of hemophilia B at time of diagnosis, n (%)
Severe (FIX <1%)
Moderately severe (FIX ≥1% and ≤2%)
44 (81.5)
10 (18.5)
Positive HIV status, n (%) 3 (5.6)
Prior hepatitis B infection, n (%) 3 (5.6)
Prior hepatitis C infection, n (%) 27 (50.0)
Pre-screening FIX treatment (n, %)
Extended half-life
Standard half-life
31 (57.4)
23 (42.6)
Detectable NAbs at baseline, n (%, max titer) 23 (42.6, 3212.3)
0 bleeds in lead-in, n (%) 16 (29.6)
Cumulative bleeds in lead-in, n 123
HIV, human immunodeficiency virus; NAb, neutralizing antibody; SD, standard deviation.
HOPE-B pivotal trial: baseline demographics
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• FIX activity increased rapidly to a mean of 37% at Month 6, meeting the first primary endpoint
• Change from baseline +36% (SD 19.7), p<0.0001
aUncontaminated central laboratory data (the visit did not occur within 10 days of exogeneous FIX use). FIX levels beginning with the Week 3 assessment were used in the analysis. Subjects with 0 uncontaminated central-laboratory
post-AMT-061 values had change from baseline assigned to zero for this analysis and had their post-baseline values set equal to their baseline value. Baseline factor IX was imputed based on subject’s historical hemophilia B severity
documented on the case record form. If the patient had documented severe factor IX deficiency (FIX plasma level < 1%), their baseline factor IX activity level is imputed as 1%. If the subject had documented moderately severe factor IX
deficiency (factor IX plasma level ≥1% and ≤ 2%), their baseline factor IX activity level was imputed as 2%.
SD, standard deviation.
Overview of FIX activity: Up to 26 weeks (month 6)
N 52 51 53 48 51 51 47 45 49 52 50 47 54
0
10
20
30
40
50
60
70
80
90
100
1 2 3 4 5 6 7 8 9 10 11 12 Month 4 Month 5 Month 6
FIX
activity,
centr
al one
-sta
ge (
%)
Week
Q1-Q3 Mean Min/maxMedian
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Over 80% of patients achieved FIX activity ≥20% at 6 months
• Distribution of FIX activity at 6 months post-dose
Percent of All
Patients (N=53):
FIX at
6 months:
98% FIX ≥ 5%
83% FIX ≥ 20%
68% FIX ≥ 30%
38% FIX in normal range
(≥ 40%)
0
2
4
6
8
10
12
14
16
18
Num
ber
of
patients
, n
FIX activity (%) at 6 months, central one stage assay
Steroid use fortransaminases
4%
Without steroid
use
2%
11%
15%
30%
15%13%
4%
2%
4%
Per-Protocol population (N = 53), which included all subjects from the FAS who adhered to a stable and adequate prophylaxis use during the lead-in phase, completed assessments through the 6 month visit, and had no major protocol deviations that
impacted the interpretation of efficacy. Percentages represent proportion of the Per-Protocol population. Subjects with 0 uncontaminated central-laboratory post-AMT-061 values had their post-baseline values set equal to their baseline value
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Uncontaminated central laboratory data (the visit did not occur within 10 days of exogeneous FIX use). FIX levels beginning with the Week 3 assessment were used in the analysis. Subjects with 0 uncontaminated central-laboratory post-AMT-061 values had change from baseline assigned to zero for this analysis and had their post-baseline values set equal to their baseline value. Baseline factor IX was imputed based on subject’s historical hemophilia B severity documented on the case record form. If the patient had documented severe factor IX deficiency (FIX plasma level < 1%), their baseline factor IX activity level is imputed as 1%. If the subject had documented moderately severe factor IX deficiency (factor IX plasma level ≥1% and ≤ 2%), their baseline factor IX activity level was imputed as 2%.
SD, standard deviation.
Overview of FIX activity: Sustained beyond 26 weeks
N 52 51 53 48 51 5147 45 49 52 50 47 154 35 24 23 14 4 3
0
20
40
60
80
100
120
1 2 3 4 5 6 7 8 9 10 11 12 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 11 Month 12 Month 13 Month 14 Month 15 Month 16 Month 17 Month 18
FIX
activity,
ce
ntr
al o
ne
-sta
ge
(%
)
Week
Week 26Q1-Q3 Mean Min/maxMedian
Month 18
▪ One patient has reached 18 months of follow up
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▪ One patient with a titer of 3212.3 did not respond (data not shown)
aPer-Protocol population (N = 53), which included all subjects from the full analysis set who adhered to a stable and adequate prophylaxis use during the lead-in phase, completed assessments through the 6-month visit, and had no major protocol deviations that impacted the interpretation of efficacy; NAb, neutralizing antibody.
No correlation of pre-existing NABs with FIX activity identified up to a titer of 678
Pearson product-moment correlation (95% CI): -0.28 (-0.51, -0.00)
Spearman correlation coefficient (95% CI): -0.27 (-0.50, 0.01)
R2 = 0.078
n=52
5% Factor IX Activity
700500300200100101
Baseline neutralizing antibodies to AAV5 (titer)
Mo
nth
6 o
ne
-sta
ge
aP
TT
Fa
cto
r IX
activity (
%)
0
20
40
60
80
100
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Substantial reduction in all bleeds post treatment
*Other comprises bleeds associated with unrelated medical/dental procedures and of unknown etiology.
The post-treatment period was the number of days of observation within the time interval, excluding information prior to Day 21. Only bleeds that were assessed by the investigator to be new and true were considered.
2 patients remaining on prophylaxis had no bleeds in the lead in and 2 untreated bleeds (1 traumatic/1 spontaneous) post-treatment, and 5 treated bleeds (3 spontaneous/2 unknown) in lead in and none post-treatment, respectively
▪ Treated bleeds decreased by 91%
▪ Total bleeds decreased by 83%
Lead-in
N = 54
Week 0-26
N = 54
Total, nTreated,
n (% of total)Total, n
Treated,
n (% of total)
Total cumulative bleeds 123 107 (87%) 21 10 (48%)
Spontaneous 42 37 (88%) 7 3 (43%)
Traumatic 66 55 (83%) 11 5 (45%)
Other* 15 15 (100%) 3 2 (67%)
Proportion of patients with bleeds, n (%)
At least one bleed – any type 38 (70%) 15 (28%)
At least one treated bleed 36 (67%) 7 (13%)
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aTwo patients remain on prophylaxis (1 patient received a partial infusion, 1 patient FIX expression remained <2%).
bThe post-treatment period was the number of days of observation within the time interval, inclusive of Day 21 onwards. FIX use in abstract annualized from Day 22 (inclusive). Factor IX replacement therapy
use for invasive procedures is not included in analysis
cPer-Protocol population (N = 53), which included all subjects from the FAS who adhered to a stable and adequate prophylaxis use during the lead-in phase, completed assessments through the 6-month visit,
and had no major protocol deviations that impacted the interpretation of efficacy
IU, international unit; SD, standard deviation; yr., year.
Substantial reductions in FIX replacement use post treatment
Lead-in
N = 54
Week 0-26
N = 54
Patient on prophylaxisa, n (%) 54 (100%) 2 (4%)
FIX usage (IU/yr/pt), mean (SD)b 290,769
(170,148)
12,537a
(36,218)
▪ 98% of patients were able to discontinue prophylaxis and remain prophylaxis-free in
the Per-Protocol populationc
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▪ 53 patients had 324 AEs post-treatment, of which 37 patients had a total of 88 TRAE
▪ The majority (79.6%) of treatment-related AEs were mild
▪ 9 patients received steroid treatment for transaminase elevations
▪ All discontinued steroid use prior to Week 26
▪ FIX activity was preserved in the mild range (8%-39%)
▪ 7 patients experienced infusion related reactions*▪ Infusion discontinued in 1 patient (received ~10%
of dose)
▪ Infusion completed successfully in remaining 6
▪ Interrupted in 3, received antihistamines and steroids and restarted
▪ No interruption in 3
* Here the set of “infusion related reactions” is broader than just the preferred term “infusion-related
reactions”.
ALT, alanine aminotransferase; AST, aspartate aminotransferase; IRR, infusion-related reaction.
aAn Incident AE is an adverse event that began or worsened within the period. Related = possibly related
or related.
Treatment-related adverse events
AE, preferred term N = 54
n (%)
At least one related incident AEa 37 (68.5)
Influenza like illness 7 (13.0)
Headache 7 (13.0)
ALT increased 7 (13.0)
AST increased 5 (9.3)
Fatigue 4 (7.4)
Blood creatine phosphokinase increased 4 (7.4)
Nausea 4 (7.4)
Infusion-related reactions 4 (7.4)
Dizziness 3 (5.6)
Arthralgia 3 (5.6)
▪ No inhibitors to FIX were reported
▪ No relationship between safety and NAbs was observed
Treatment-related AEs with an incidence ≥5% post treatment
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Conclusions
▪ First report of a phase 3 study in patients with Hemophilia B and the largest gene therapy trial
cohort reported to date
▪ Mean FIX activity significantly increased to near-normal levels at 26 weeks post-etranacogene
dezaparvovec, meeting the first co-primary endpoint
▪ No requirement for prophylactic immunosuppression
▪ 52/53 patients receiving a full dose responded
▪ Included patients with pre-existing anti-AAV5 titers up to 678
▪ Patients were able to discontinue prophylaxis
▪ Bleeding was abolished in the majority of patients throughout the 26 weeks
▪ Most common safety findings were transaminase elevations requiring steroid treatment and
infusion-related reactions, supporting a safety profile consistent with early phase studies
▪ Final analysis is planned at 1 year to support marketing authorization applications
NAbs, neutralizing antibodies,
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Acknowledgements
We thank the participating HOPE-B clinical trial subjects and their
families, the study sites’ staff and the trial team.
HOPE-B co-authors
Steven W. Pipe, M.D.1
Michael Recht, M.D., Ph.D. Niamh M. O’Connell, M.B, Ph.D. Robert Klamroth, M.D, Ph.D. Rebecca Kruse-Jarres, M.D., M.P.H
Nigel S. Key, MBChB K. John Pasi, MBChB, Ph.D. Richard Lemons, M.D., Ph.D. Adam Kotowski, M.D.
Frank W.G. Leebeek, M.D. Peter Kampmann, M.D. Nathan Visweshwar, M.D. Doris Quon, M.D., Ph.D.
Giancarlo Castaman, M.D. Karina Meijer, M.D., Ph.D., Shelley Crary, M.D. Michael Wang, M.D.
Susan Lattimore, R.N. Annette von Drygalski, M.D., Ph.D. Syed R.S. Kazmi, M.D. Allison P. Wheeler, M.D.
Paul van der Valk, M.D. Guy Young, M.D. Emily Symington, MBChB Eileen K. Sawyer, Ph.D.
Kathelijne Peerlinck, M.D., Ph.D. Cedric Hermans, M.D. Miguel A. Escobar, M.D. Stephanie Verweij
Michiel Coppens, M.D., Ph.D. Jan Astermark, M.D., Ph.D. Esteban Gomez, M.D. Valerie Colletta, MSc,
Naghmana Bajwa, M.D. Robert Gut, M.D., Ph.D. Wolfgang Miesbach, M.D., Ph.D.
1University of Michigan, Ann Arbor, MI, USA
Research Analyst Q&A